2009-2011年本院病原菌分布及药物敏感性变化

目的了解2009-2011年辽宁医学院附属第一医院病原菌的分布及抗生素敏感性变化趋势。方法回顾性分析2009年1月-2011年12月临床各类标本分离的3 947株病原菌,进行分布构成比情况及药物敏感性分析。分离所得菌株用美国德灵公司Microscan-walkaway96全自动微生物鉴定仪进行菌株鉴定和药敏实验。结果在分离的3 947株病原菌中,革兰阴性菌3 169株（80.3%）,革兰阳性菌778株（19.7%）。大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌为主要的革兰阴性病原菌。大肠埃希杆菌、肺炎克雷伯杆菌产超广谱β-内酰胺酶（extended spectrum beta-lactamases,ESBLs）率分别为55%、45%。金黄色葡萄球菌和表皮葡萄球菌为主要的革兰阳性病原菌。未检出对万古霉素耐药的葡萄球菌,耐甲氧西林金黄色葡球菌上升趋势明显。结论 2009-2011年病原菌分布变化明显,抗菌药物敏感性下降,临床科室应依据药敏实验结果合理选择抗生素。

Distribution of pathogenic bacteria in Affiliated Hospital of Liaoning Medical College from 2009 to 2011 and their drug sensitivity

Objective To study the distribution of pathogenic bacteria in Affiliated Hospital of Liaoning Medical College from 2009 to 2011 and their sensitivity to antibiotics.Methods The distribution of 3 947 pathogenic bacteria isolated from different clinical samples in January 2009–December 2011 and their sensitivity were retrospectively analyzed.The isolated pathogenic bacteria were identified with Microscan walkaway-96 automatic identifier and their drug sensitivity was tested.Results Of the 3 947 isolated pathogenic bacteria,3 169（80.3%） were Gram-negative and 778（19.7%） were Gram-positive.Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Acinetobacter baumannii were the frequently isolated Gram-negative bacteria.ESBLsproducing Escherichia coli and Klebsiella pneumoniae accounted for 55% and 45%,respectively.Staphylococcus aureus and Staphylococcus epidermidis were the main Gram-positive pathogens.No vancomycin-resistant Staphylococci were detected.The number of MRSA-resistant Staphylococci aureus increased significantly.Conclusion The distribution of pathogenic bacteria was significantly changed from 2009 to 2011 with their sensitivity to antibiotics decreased,indicating that antibiotics should be rationally used in clinical departments according to the drug sensitivity testing.